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Surgical Treatment of a Submitral Left Ventricular Aneurysm and the Patient Present with Recurrent Ventricular Tachycardia

재발성 심실성 빈맥이 동반된 승모판하 좌심실류의 외과적 치료

  • Kim, Young-Sam (Department of Thoracic and Cardiovascular Surgery, Inha University Hospital) ;
  • Cho, Jung-Soo (Department of Thoracic and Cardiovascular Surgery, Bucheon Sejong General Hospital) ;
  • Yoon, Yong-Han (Department of Thoracic and Cardiovascular Surgery, Inha University Hospital) ;
  • Kim, Joung-Taek (Department of Thoracic and Cardiovascular Surgery, Inha University Hospital) ;
  • Baek, Wan-Ki (Department of Thoracic and Cardiovascular Surgery, Inha University Hospital) ;
  • Kim, Kwang-Ho (Department of Thoracic and Cardiovascular Surgery, Inha University Hospital)
  • 김영삼 (인하대학교병원 흉부외과) ;
  • 조정수 (부천세종병원 흉부외과) ;
  • 윤용한 (인하대학교병원 흉부외과) ;
  • 김정택 (인하대학교병원 흉부외과) ;
  • 백완기 (인하대학교병원 흉부외과) ;
  • 김광호 (인하대학교병원 흉부외과)
  • Received : 2009.10.01
  • Accepted : 2009.10.20
  • Published : 2010.04.05

Abstract

Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.

승모판하 좌심실류는 흑인들에서 주로 발생하는 드문 질환이다. 저자들은 심실성 빈맥을 동반한 승모판하 좌심실류의 수술 치험을 보고하고자 한다. 환자는 68세 남자로 수술은 통상적인 저체온 심폐 바이패스 하에서 진행하였다. 심첨부를 들어올리고 좌심실 후방 기저부에 위치한 심실류에 직접 종절개를 넣고 먼저 심실류의 목에 해당하는 부위의 심내막을 돌아가며 고주파절제술(radiofrequency ablation)을 시행한 다음 승모판 및 판막하 구조물을 피해 첨포를 이용한 심실내 심실류봉합술(endoaneurysmorrhaphy)을 시행하였다. 수술 후 경과는 양호하였으며 현재 술 후 2년 정도 경과한 상태로 부정맥의 재발이나 승모판 기능이상은 관찰되지 않고 있다.

Keywords

References

  1. Janeira LF, Talit U, Parker R, Hughes CE, Tuna IC. Surgical management of ventricular tachycardia in subannular left ventricular aneurysm. Ann Thorac Surg 1995;60:438-4 https://doi.org/10.1016/0003-4975(95)00099-7
  2. Abrahams DG, Barton CJ, Cockshott WP, Edington GM, Weaver EJM. Annular subvalvular left ventricular aneurysm. Q J Med 1962;31:345-60
  3. Beck W, Schrire V. Idiopathic mitral subannular left ventricular aneurysm in the Bantu. Am Heart J 1969;78:28-33 https://doi.org/10.1016/0002-8703(69)90283-X
  4. Antunes MJ. Submitral left ventricular aneurysm. Correction by a new transatrial approach. J Thorac Cardiovasc Surg 1987;94:241-5
  5. Esposito F, Renzulli A, Festa M, et al. Submitral left ventricular aneurysm. Report of 2 surgical cases. Tex Heart Inst J 1996;23:51-3
  6. Fitchett DH, Kanji M. Mitral subannular left ventricular aneurysm. A case presenting with left ventricular tachycardia. Br Heart J 1983,50:594-6 https://doi.org/10.1136/hrt.50.6.594
  7. Chi NH, Yu HY, Chang CI, Lin FY, Wang SS. Clinical surgical experience of congenital submitral left ventricular aneurysm. Thorac Cardiovasc Surg 2004;52:110-6 https://doi.org/10.1055/s-2004-817808